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Threat assessment involves identifying, assessing, and managing threats of violence prompted by warning behaviours, and has only recently been applied to terrorism. As an emerging field, what works, for which offence types, and in which settings, is largely unknown. A crucial first step to this is understanding how threat assessment has been implemented in practice. This systematic review analyses case study literature describing the structure and operations of existing targeted violence threat assessment teams. Included studies described 22 threat assessment teams in Europe, the USA, and Australia, and covered six targeted violence types. Teams were compared based on their objectives and development, team structure, threat assessment and referrals processes, interventions, case management, and quality assurance mechanisms. Findings show the typical threat assessment team is developed following literature reviews and expert consultation, follows a public health approach with emphasis on prevention over prediction, and incorporates structured case management following intervention. Teams are multidisciplinary, including representatives from at least law enforcement and mental healthcare. Threat assessment comprises several processes of triage before in-depth assessment utilising the full team and available resources. Very few teams have been subject to publicly accessible and/or peer-reviewed evaluation, which hinders any comparisons of effectiveness or confidence in evidence-based practices. Beyond this, main points of variation are whether interventions are carried out in-house or outsourced to services elsewhere, and the resources and tools used in assessment. The few dedicated violent extremism teams, for example, lack the stable evidence base and therefore suitable set of empirically validated risk assessment instruments at other teams’ disposal. Overall, this structured understanding of the existing implementation of threat assessment can aid development of future teams in such an emerging space. However, future evaluative research of the operation of these teams is crucial, and lacking: what works, where, and for whom remains uncertain.